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A hospital isn't enough

September 09, 2007|E. Richard Brown | E. Richard Brown is director of the UCLA Center for Health Policy Research and a professor at the UCLA School of Public Health.

The slow execution of Martin Luther King Jr.-Harbor Hospital cures none of the health problems of South Los Angeles. Nearly one in three of this community's adults and children are uninsured -- nearly twice the rate of West L.A., the San Fernando Valley and the South Bay. Four in 10 residents of South L.A. rely on county health facilities and community clinics when they need healthcare. Closing the hospital will only exacerbate the barriers to access.

We need to closely monitor the effect of the hospital's closure on the community and on other hospitals, and we need an independent assessment of whether the hospital's beds and emergency room are indispensable to the community -- and whether, therefore, the hospital must be reopened in one form or another.

Even if the hospital is ultimately reopened, it will meet only part of South L.A.'s health needs. That's because in addition to needing a good hospital, the community badly needs basic medical care. The county and the state must provide increased support to community health centers to serve this community.

But while such clinics, whether county or community run, can greatly improve access to primary care, they can't provide residents with the specialty care they also need -- medical care to manage difficult cases of diabetes, asthma, heart disease and other conditions that ravage this community. That's where a revamped King-Harbor can play a crucial role in providing the specialty care that the community needs.

South Los Angeles residents have the highest rates of obesity in the county and suffer from high rates of other conditions -- including psychological distress, unemployment and neighborhood violence -- that produce chronic disease and early death.

Health education programs and other traditional public health services are vital. But these communities also need better access to nutritious food -- grocery stores and farmers markets to replace many of the convenience and liquor stores that dominate the landscape. And South L.A. children and adults need better schools, more and safer parks and recreation centers, more effective community policing and decent jobs to address the underlying conditions of violence, lack of education and hopelessness that can grip a neighborhood in poverty.

L.A. County cannot have a vital future with a vibrant economy if the health of a major community is ignored.

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